| NPI | 1346403953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A126902) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A126902) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2019-12-02 |